Dr. Mary Reeves is a Family Medicine physician. She spent her 22 clinical practice years at First Street Family Health (FSFH), a 4-doctor independent practice serving a rural population in the central Colorado mountains. Salida, Colorado is a small town (pop. 5300) that has a critical access hospital; the only hospital for 1 hour in any direction and is 2-3 hours from tertiary care. FSFH started its transformation journey as part of the Comprehensive Primary Care Initiative (CPCI) in 2011. By coordinating patient care, we were able to reduce emergency room visits by 22% in 1.5 years despite verall growth in our practice. Implementing Team Based care strategies opened access, improved office efficiency and morale and increased revenue.